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Influence of scleral lenses on visual acuity and aberrations in patients with irregular cornea

https://doi.org/10.33791/2222-4408-2019-2-32-39

Abstract

Purpose: To analyze changes of functional parameters and aberrations before fitting and after using rigid gas-permeable scleral lenses (RGPSCL) in patients with irregular cornea.

Material and methods. 21 patients (29 eyes) with irregular astigmatism of various etiology were enrolled in this study. The patients could not achieve good visual aсuity in glasses, standard soft or rigid corneal contact lenses. Complex ophthalmologic examination was performed: autorefractometry, visometry, biomicroscopy, computer corneal topography, aberrometry on “OPD-Scan II” (“Nidek”,Japan) before fitting scleral lenses and during the period of their wearing.

Results and discussion. The results demonstrated significant visual acuity improvement after RGPSCL fitting in all observed patients. UCVA amounted to 0.1±0.18, BCVA in glasses amounted to 0.4±0.26, BCVA in RGPSCL amounted to 0.7±0.1. An increase of best-corrected visual acuity in RGPSCL was statistically significant in patients after keratoplasty, after intra-stromal corneal ring segments (ICRS) implantation, after refractive laser surgery (RLS) and in cases of mixed astigmatism. We have found that the correction of ke-ratoconus with the use of RGPSCL resulted in a decrease of the root mean square value (RMS), measured in the3 mm and5 mm zones by 2.5 times and 4 times, respectively. In patients wearing RGPSCL after keratoplasty, statistically significant decrease in RMS was observed in the3 mm zone (by 3.85 times) and in the5 mm zone (by 2.99 times). In patients wearing RGPSCL after implantation of intrastromal corneal ring segment (ICRS), RMS in the3 mm zone decreased by 1.5 times. In patients wearing RGPSCL after refractive laser surgery (RLS) RMS was 2.5 times lower in the3 mm zone and 2.8 times lower in the5 mm zone. In case of mixed astigmatism correction with RGPSCL, RMS increased by 1.6 times in the3 mm zone and practically did not change in the5 mm zone.

Conclusion. The results obtained demonstrated significant visual acuity improvement in all observed patients. The sub-lens-space filled with tear forms a unified “cornea-tear-scleral contact lens” optic system that corrects

About the Authors

O. I. Tikhonova
S.N. Fedorov NMRC "MNTK "EYE MICROSURGERY", Cheboksary department
Russian Federation

M.D. of Contact Correction Office

10 Tractorostroiteley St., Cheboksary, 428028, Russian Federation




N. P. Pashtaev
S.N. Fedorov NMRC "MNTK "EYE MICROSURGERY", Cheboksary department; SAI SVE "The Postgraduate Medical Education Institute" of Health Ministry of the Chuvash Republic; FSEE of HPE "The Chuvash state university named after I.N. Ulyanov"
Russian Federation

Med.Sc.D., Professor, Director, Cheboksary department of S.N. Fedorov NMRC "MNTK "EYE MICROSURGERY", Head of the Ophthalmology Department, Postgraduate Medical Education Institute of Health Ministry of the Chuvash Republic; Head of the Ophthalmology and Otolaryngology Department, Chuvash state university named after I.N. Ulyanov.

10 Tractorostroiteley St., Cheboksary, 428028;

27 M. Sespel St., Cheboksary, 428018;  

45 Moskovskiy pr., Cheboksary, 428015, Russian Federation;



N. A. Pozdeyeva
S.N. Fedorov NMRC "MNTK "EYE MICROSURGERY", Cheboksary department; SAI SVE "The Postgraduate Medical Education Institute" of Health Ministry of the Chuvash Republic
Russian Federation

Med.Sc.D., Ophthalmologist, Deputy Director for Science

10 Tractorostroiteley St., Cheboksary, 428028;

27 M. Sespel St., Cheboksary, 428018;

45 Moskovskiy pr., Cheboksary, 428015, Russian Federation



A. V. Myagkov
Academy of Medical Optics and Optometry
Russian Federation

Med.Sc.D., Professor, Director

63B, bld. 4, Mikhalkovskaya St., Moscow, 125438, Russian Federation



S. G. Bodrova
S.N. Fedorov NMRC "MNTK "EYE MICROSURGERY", Cheboksary department
Russian Federation

Ph.D., Ophthalmologist, Head of the Contact Correction Department

10 Tractorostroiteley St., Cheboksary, 428028, Russian Federation



M. M. Sitka
S.N. Fedorov NMRC "MNTK "EYE MICROSURGERY", Cheboksary department
Russian Federation

Ophthalmologist of Contact Correction Office

10 Tractorostroiteley St., Cheboksary, 428028, Russian Federation



L. N. Volkova
S.N. Fedorov NMRC "MNTK "EYE MICROSURGERY", Cheboksary department
Russian Federation

M.D. of Contact Correction Office

10 Tractorostroiteley St., Cheboksary, 428028, Russian Federation



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Review

For citations:


Tikhonova O.I., Pashtaev N.P., Pozdeyeva N.A., Myagkov A.V., Bodrova S.G., Sitka M.M., Volkova L.N. Influence of scleral lenses on visual acuity and aberrations in patients with irregular cornea. The EYE GLAZ. 2019;21(2 (126)):32-39. (In Russ.) https://doi.org/10.33791/2222-4408-2019-2-32-39

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ISSN 2222-4408 (Print)
ISSN 2686-8083 (Online)